20-year-old Female Cross Country Runner Presenting With Exertional Right Thigh Pain

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20-year-old Female Cross Country Runner Presenting With Exertional Right Thigh Pain - Page #1

Author: Ryan Allen, MD Senior Editor: Kevin Gray, MD Editor: Brian Atkinson, MD Patient Presentation: A 20-year-old female collegiate track and field runner presented with exertional right upper thigh pain without recent injury. History: A 20-year-old female presented with pain in the right upper leg affecting speed while running. She was a seasoned track athlete with no major past medical history aside from posterior tibialis tendinopathy, plantar fasciitis, and calcaneal bone stress injury. Her pain and reduced running speed began 2 months prior to the initial clinic visit and localized to her right upper anterior thigh region with no pain below her knees. She also described a cold sensation in her right foot as well as right leg weakness during these episodes. Symptoms began around mile 1, but she was able to run up to 14 miles at a reasonable pace. Symptoms resolved with rest. No rest or night pain. No prior right leg injuries or family history of vascular issues. No history of smoking, oral contraceptive pills, trauma, or abdominal surgery. She had COVID 3 months prior to presentation. Physical Exam: Lean, otherwise well appearing female. Cardiac exam: Regular rate and rhythm, No murmurs, rubs, or gallops, No jugular venous distention, 2+ pulses in all peripheral arteries of upper and lower extremities. Abdominal exam: Soft, no hepatosplenomegaly, no tenderness, no masses. Right leg: Normal range of motion, No obvious deformity, Normal gait, Negative FABER/FADIR, Negative log roll, Negative straight leg, Negative Ober, Strength 5/5 in all hip and knee movements, No tenderness to palpation at hip/knee/SI/lumbar region. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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